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Contents

Introduction
Special Considerations for Measurement of Diagnostic Safety
   Defining Diagnostic Errors and Diagnostic Performance
   Understanding the Multifactorial Context of Diagnostic Safety
   Choosing Data Sources for Measurement
   Learning From Known Incidents and Reports
   Learning From Existing Large Datasets
   Synthesizing Data and Enhancing Confidence in Measurement
Getting Ready for Measurement: Overcoming Barriers and Taking Next Steps
Conclusion
References

Prepared for:

´óÏóÊÓƵ
5600 Fishers Lane
Rockville, MD 20857
www.ahrq.gov

Contract Number HHSP233201500022I/75P00119F37006

Prepared by:

Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E.
DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX
Hardeep Singh, M.D., M.P.H.
Andrea Bradford, Ph.D.

MedStar Health Institute for Quality and Safety, ´óÏóÊÓƵPatient Safety Learning Lab
Grantee, and ´óÏóÊÓƵNational Advisory Council
Christine Goeschel, Sc.D., RN

This project was funded under contract number HHSP233201500022I/75P00119F37006 from the
´óÏóÊÓƵ (AHRQ), U.S. Department of Health and Human Services. The authors are solely responsible for this document’s contents, findings, and conclusions, which do not necessarily represent the views of AHRQ. Readers should not interpret any statement in this product as an official position of ´óÏóÊÓƵor of the U.S. Department of Health and Human Services. None of the authors has any affiliation or financial involvement that conflicts with the material presented in this product.

Public Availability Notice. This product is made publicly available by ´óÏóÊÓƵand may be used and reprinted without permission in the United States for noncommercial purposes, unless materials are clearly noted as copyrighted in the document. No one may reproduce copyrighted materials without the permission of the copyright holders. Users outside the United States must get permission from ´óÏóÊÓƵto reprint or translate this product. Anyone wanting to reproduce this product for sale must contact AHRQ for permission. 

Citation of the source is appreciated.

Suggested citation: Singh H, Bradford A, Goeschel C. Operational Measurement of Diagnostic Safety: State of the Science. Rockville, MD: ´óÏóÊÓƵ; April 2020. AHRQ Publication No. 20-0040-1-EF.